What workers' compensation pays
In New York, workers' compensation generally covers medical treatment for the work injury and cash benefits that replace part of your lost wages while you cannot work. The cash benefit is based on your earnings before the accident, subject to a cap, so pay stubs and records of overtime or a second job can matter. If the injury leaves a lasting loss of use of an arm, a leg, a hand, or another listed body part, a separate award may be available once your condition has stopped improving. When a worker dies, benefits may be payable to a spouse, children, or other dependents. None of this requires proof that the employer was careless.
What it does not cover
Workers' compensation does not pay for pain and suffering, and it replaces only part of lost income. In exchange for that limited but no-fault coverage, a lawsuit against your own employer is generally barred, with narrow exceptions. Fuller damages may be available from someone else, such as the maker of a defective machine or the owner or contractor at a construction site, through a separate claim. When that happens, the compensation insurer usually has a lien on the outside recovery for what it paid, and settling the outside case generally needs the insurer's consent, so the two have to be coordinated. The gap between compensation benefits and full damages is often what leads people to look beyond the compensation claim.
Keeping benefits flowing
Benefits can be delayed or stopped when paperwork lags, so keep the claim moving. Treat with providers authorized by the Board, keep your appointments, and confirm that each provider is sending reports to the Board. Keep copies of every notice from the insurer and the Board, because a reduction or dispute may call for a prompt response, and Board decisions carry their own deadlines. In a first meeting we review whether the claim has been accepted, whether your wage rate was calculated correctly, and whether an outside claim deserves a closer look. If a public agency owned the site, a notice of claim against it may be due very quickly.
